Multisubstituted aromatic compounds as serine protease inhibitors

Abstract

There are provided inter alia multisubstituted aromatic compounds useful for the inhibition of kallikrein, which compounds include substituted pyrazolyl or substituted triazolyl. There are additionally provided pharmaceutical compositions. There are additionally provided methods of treating and preventing certain diseases or disorders, which disease or disorder is amenable to treatment or prevention by the inhibition of kallikrein.

What is claimed is: 
     
       1. A method for treating a disease or disorder responsive to inhibition of thrombin in a subject, comprising administering a compound to a subject in need thereof in an amount effective to treat or prevent said disease or disorder, wherein the compound has the following formula: 
       
         
           
           
               
               
           
         
         or pharmaceutically acceptable salt thereof; 
         wherein 
         L 1  is —NR 7 —; 
         L 2  a bond, substituted or unsubstituted alkylene, —SO 2 —, or —C(═O)—, provided that if L 2  is a bond, R 2  is hydrogen; 
         L 5  is a bond or substituted or unsubstituted alkylene, provided that if L 5  is a bond, R 5  is hydrogen; 
         R 1  is hydrogen, substituted or unsubstituted alkyl, substituted or unsubstituted heteroalkyl, substituted or unsubstituted heterocycloalkyl, substituted or unsubstituted heterocycloalkenyl, substituted or unsubstituted aryl, substituted or unsubstituted fused ring aryl, or substituted or unsubstituted heteroaryl; 
         R 2  and R 5  are independently hydrogen, substituted or unsubstituted alkyl, substituted or unsubstituted heteroalkyl, substituted or unsubstituted cycloalkyl, substituted or unsubstituted cycloalkenyl, substituted or unsubstituted heterocycloalkyl, substituted or unsubstituted heterocycloalkenyl, substituted or unsubstituted aryl, substituted or unsubstituted fused ring aryl, or substituted or unsubstituted heteroaryl; and 
         R 7  is hydrogen, or substituted or unsubstituted alkyl. 
       
     
     
       2. The method according to  claim 1 , wherein L 2  is substituted or unsubstituted alkylene or —C(═O)—, and R 2  is substituted or unsubstituted alkyl, substituted or unsubstituted cycloalkyl, substituted or unsubstituted cycloalkenyl, substituted or unsubstituted heteroalkyl, substituted or unsubstituted heterocycloalkyl, substituted or unsubstituted heterocycloalkenyl, substituted or unsubstituted aryl, substituted or unsubstituted fused ring aryl, or substituted or unsubstituted heteroaryl. 
     
     
       3. The method according to  claim 1 , wherein said disease or disorder is at least one of a thrombotic disorder, a disease or disorder involving a blood clot thrombus, and a disease or disorder which can lead to formation of a blood clot thrombus. 
     
     
       4. The method according to  claim 3 , wherein said thrombotic disorder comprises at least one of acute coronary syndrome, thromboembolism, and thrombosis. 
     
     
       5. The method according to  claim 4 , wherein the thromboembolism comprises at least one of venous thromboembolism, arterial thromboembolism, and cardiogenic thromboembolism. 
     
     
       6. The method according to  claim 5 , wherein the venous thromboembolism comprises at least one of deep vein thrombosis and pulmonary embolism. 
     
     
       7. The method according to  claim 6 , wherein the at least one of deep vein thrombosis and pulmonary embolism occurs following a medical procedure. 
     
     
       8. The method according to  claim 3 , wherein said thrombotic disorder involves dysfunctional coagulation or disseminated intravascular coagulation. 
     
     
       9. The method according to  claim 8 , wherein the subject is undergoing percutaneous coronary intervention (PCI). 
     
     
       10. The method according to  claim 3 , wherein said thrombotic disease or disorder involves a blood clot thrombus or can lead to formation of a blood clot thrombus and further involves at least one of stroke and one or more transient ischemic attacks (TIA). 
     
     
       11. The method according to  claim 10 , wherein said thrombotic disease or disorder involving a blood clot thrombus or can lead to formation of a blood clot thrombus further involves stroke and wherein the subject has non-valvular atrial fibrillation. 
     
     
       12. The method according to  claim 3 , wherein said thrombotic disease or disorder involves a blood clot thrombus or can lead to formation of a blood clot thrombus and further involves pulmonary hypertension. 
     
     
       13. The method according to  claim 12 , wherein the pulmonary hypertension is caused by at least one of one or more left heart disorder and chronic thromboembolic disease. 
     
     
       14. The method according to  claim 12 , wherein the pulmonary hypertension is associated with at least one of one or more lung disease, including pulmonary fibrosis (idiopathic or otherwise), and hypoxia. 
     
     
       15. The method according to  claim 1 , wherein said disease or disorder comprises at least one of fibrosis, Alzheimer's Disease, multiple sclerosis, pain, cancer, inflammation, and Type I diabetes mellitus. 
     
     
       16. The method according to  claim 1 , wherein the disease or disorder involves recurrent cardiac events after myocardial infarction. 
     
     
       17. The method according to  claim 5 , wherein the venous thromboembolism is associated with at least one of formation of a thrombus within a vein associated with one or more acquired or inherited risk factors and embolism of peripheral veins caused by a detached thrombus. 
     
     
       18. The method according to  claim 17 , wherein the one or more risk factors comprise a previous venous thromboembolism. 
     
     
       19. The method according to  claim 5 , wherein the cardiogenic thromboembolism is due to formation of a thrombus in the heart associated with at least one of cardiac arrhythmia, a heart valve defect, prosthetic heart valves or heart disease, and embolism of peripheral arteries caused by a detached thrombus. 
     
     
       20. The method according to  claim 19 , wherein the detached thrombus is in the brain (ischemic stroke). 
     
     
       21. The method according to  claim 20 , wherein the detached thrombus causes a transient ischemic attack (TIA). 
     
     
       22. The method according to  claim 19 , wherein the cardiogenic thromboembolism is due to non-valvular atrial fibrillation. 
     
     
       23. The method according to  claim 4 , wherein the thrombosis is arterial thrombosis. 
     
     
       24. The method according to  claim 23 , wherein the arterial thrombosis is due to one or more underlying atherosclerotic processes in the arteries. 
     
     
       25. The method according to  claim 24 , wherein the one or more underlying atherosclerotic processes in the arteries cause at least one of obstruction or occlusion of an artery, myocardial ischemia (angina pectoris, acute coronary syndrome), myocardial infarction, obstruction or occlusion of a peripheral artery (ischemic peripheral artery disease), and obstruction or occlusion of the artery after a procedure on a blood vessel (reocclusion or restenosis after transluminal coronary angioplasty, reocclusion or restenosis after percutaneous transluminal angioplasty of peripheral arteries). 
     
     
       26. The method according to  claim 1 , wherein the treatment or prevention comprises an adjunct therapy. 
     
     
       27. The method according to  claim 26 , wherein the subject has myocardial infarction, and the adjunct therapy is in conjunction with thrombolytic therapy. 
     
     
       28. The method according to  claim 26 , wherein the subject has at least one of unstable angina pectoris, thrombosis, and heparin-induced thrombocytopenia, and the adjunct therapy is in combination with antiplatelet therapy. 
     
     
       29. The method according to  claim 26 , wherein the subject has non-valvular atrial fibrillation, and the adjunct therapy is in conjunction with other therapies.